Saturday, 10 October 2015

BPD Stigma and Shame Based Identity

I blog for World Mental Health Day

You're manipulative.
You're a liar
You're overreacting.
You're doing this for attention.
You should be locked away in a psych ward.
You're a psycho.
You're a danger to society.
You'll never get better.
You're faking your illness.
You are at root of your problems.

All of these judgments and stigma. All of the shame. All of the guilt. All of the blame. We're always at root of our problems, the society says. But... Is it true? No.

We live in culture where church says one thing, other religious groups say the other, the psychologists and psychiatrists say something else, the anti psychology and psychiatry people say the other. It makes it easy for us, the suffering, to put the blame on ourselves because the society - and sadly, for many of us, closest friends and family- says it is all your fault. You are the cause of the problems in your life....

But in reality, we're not the problem. We have a very invalidating environment, now and growing up. We are emotionally sensitive. We react a lot more sensitively to things and we can react to a small thing. The world cannot blame us for what we've been through. On the other side of the coin, we are often seen as the problem by friends and family. And that needs to be validated as they are thinking we're crazy, loopy, and off our heads because of the illness we have. Because they don't suffer from it but with us, they can say we're the problem because it is unusual behaviour to them.

To address the stigma surrounding BPD..... We are not manipulative. We can come across this way, but in reality, we are working with what we have in the moment. If abandonment is apparent to us, imagined or real, we might turn to self harm and suicide threats or behaviours or other things to get people back in our lives to help us regulate ourselves. That might come across as manipulative, but in reality, we have not got the interpersonal skills to not act like this. We're not faking our illness to get sympathy, love or attention. It is very real to us. Very real indeed. The suffering is beyond us. World, please understand that we cannot fake intense emotions, we cannot fake feeling suicidal, we cannot fake our anger and we cannot regulate ourselves in effective ways. We understand that you feel like we are because you believe we want attention.... And it's true. We need attention because we need help and we might be asking for it in ways that seem dramatic or over the top. But, with our emotional life, we find it hard to not express our emotions intensely because they are intense on the inside of us, burning us from within. Marsha Linehan had at one point compared people with BPD to third degree burn victims, saying "People with BPD are like people with third-degree burns over 90% of the body. Lacking emotional skin, they feel agony at slightest touch or movement"
We, as people with BPD would like for the world to understand that we don't want to hurt you intentionally or even manipulate you. We love people in our lives, but when our emotional burns are touched, we will have intense reactions. Quick, intense and often impulsive reactions.
We don't want to lie to you. Ever. I don't know why people get the impression that we lie to them. We have emotional reactions that are intense. Overwhelming. And when we tell you what we're feeling of what we are thinking, please, don't think that we're lying. Again, refer to what I said previously about our reactions being different and unusual to you. We know you feel the way you do about us because our behaviours are unusual or "not normal." Believe us, we want to be normal.
We are not dangerous. Just because there are media portrayals of us that are horribly negative, and there have been people with BPD in prison for murder, assault etc. But, not all of us are like that. Not even most of us. Not even a half of us. Not even a quarter of us. We know we've had a bad portrayal in the media and you often think we're dangerous, but we're not. We're nit psychos or we don't have to be locked away. With he right kind of treatment, support from professionals and support and love from people in our lives, we can have a normal life with healthy relationships, managing our lives effectively and do what we dream. or do something beyond our wildest dreams. We have a chance in this world like you do. We know you fear for our safety and your own because of anger, suicidal attempts or threats or self injury. But we can get through it and live our lives to the fullest.
We do get better. With the right treatment, and support, we're in remission after ten years. But improvement starts with treatment. As long as we're willing to work on our problems and solving them. As long as we have a mind set on the goal of getting better (there will be slip ups along the way, and I experienced them many times over in the last nearly 11 months of DBT) we can get through it. We can do it.

All of the stigma, and our past experiences of invalidation can  lead us down feeling shame-filled all the time. We never dare to pursue what we dream because we feel shame. We developed a personality that is often self-critical, self-shaming, self-blaming and placing all guilt upon ourselves. We've learned from our environment to do so. And it gets in our way of living to the fullest, expressing ourselves, talking about our problems, standing up to people etc. It's called a shame based identity/personality. We always feel shame. Always. We never have a real break from it. We cannot express ourselves because we feel shame. I struggle with this a lot, and my awesome therapist and my great friend have recently pointed it out to me. I never thought of my self-criticism as damaging. Until maybe in the last 11 months or so. We never say what's on our minds because of the fear of shame, which feeds our cycle of self-criticism.
But we can break free from all of it and we can live to the fullest, express with confidence and be who we want to be. Takes work, dedication, time and effort. So, let's work on improving one step at a time and build the lives worth living!

BPD - From Inside and Out

I blog for World Mental Health Day

It's been a year since I have gotten my diagnosis. But I also struggle with Bipolar (of which type is unknown,) and C-PTSD. Many people see BPD sufferers as violent, unreliable, deceitful, liars, manipulative and so much more. They are people from the outside looking in.... But what's it like to be from the inside looking out?

It's a view of the world that is totally different. A little skewed sometimes. You might look at me, and your face will scare me. There have been times that I wanted to get off public transportation because of a person's face terrifying me. There are a lot of reasons people with BPD have such strong reactions to other people. But the one major player is trauma. I went through a horrific experience at the age of 12. And now, males from that ethnic group can cause panic attacks, suicidal urges or urges to self harm. The world can terrify us. We have such intense reactions to the world around us. In positive and negative ways.

Trauma leads onto suicidal and self harming behaviours in our lives. But, not necessarily. I used (sometimes still use_ self harm as means to get through highly intense emotions and emotionally demanding situations. Or as a way to deal with people's abandonment. We have a difficulty controlling out emotions because of how quickly our moods shift, what triggers us, what is happening around us, we don't have the right skills to manage and regulate emotions and crises and we often have a biological and genetics based predisposition for emotional dysregulation. In our eyes, suicide is a way out of all the pain we're experiencing. It would be an ultimate, needed escape from the suffering we;re undergoing on daily basis. We're scared to live with ourselves. We hate ourselves, in most cases. We hate and are scared of what is going on inside of us. Everything about our lives is a dark, gaping wound. This gaping wound grows as time goes on. We believe families and friends would be better off without us, as we see what we put them through or what they come to believe about us after reading about the condition on the Internet.

Our dissociation and paranoid thinking is a way to deal with the things that are going on. My BPD has dissociative personality traits. It isn't something we do intentionally to ignore you, reject what you're saying or any other negative thing you might think. Our minds disconnect, our minds want to drown out the highly distressing and emotional experience that is happening. Our dissociation might cause us to lose memory of what happened in the last 30 minutes, an hour or even a day. We might suffer from different dissociative problems; feeling like we're not real (depersonalisation), feeling like nothing is real around us (derealisation), both at the same time (I'll explain my experience of it in a minute,) Dissociative Amnesia (where you can't remember particular times of our lives or our day, even struggle to remember important personal information,) and other dissociative experiences. Depersonalisation and derealisation aspects for me were feeling like I am a ghost, floating through the streets and at the same time, the world around me feeling like a series of paintings/overly edited photos. And I am terrified when it happens. It is a scary. 

My impulsive behaviours are I guess more subtle than what other sufferer's deal with. I am on the more eating disturbance side of impulsiveness. During emotionally difficult times, I'll eat and eat and eat. But the flip side of the coin is that I might not eat anything at all in a day or very,very little. It is on impulse to distract from emotions and thoughts. I also run across roads during peak hours to distract from emotions. These behaviours are becoming more under control thanks to DBT. However, other sufferer's seek hat distraction via sex, drug addictions, driving cars really fast and others. 
The impulsive behaviours are there to help us deal with emptiness also. I feel empty all the time. Nothing satisfies the emptiness. It's like pieces of the puzzle are missing and the void is never filled or satisfied. We feel so empty, so hollow on the inside that it leads us onto suicidal and self harming paths. 

The emptiness could be the result of our identity disturbance. We have no idea of who we are. We might feel like we don't belong in the world because of how different we are to others. We have no sense our future, our present is filled with suffering, emptiness and intense relationships that the future feels so far away and we often change our courses, our jobs or our schools. We could quit courses and jobs on impulse, because we haven't found our place in the world. We often feel like outsiders, looking in on the world and seeing it through a completely different set of eyes. Our identities are completely lost. Because of the trauma we experienced, it affected our view of ourselves. Which is often filled with shame, guilt, sadness and despair.

Our moods change can change in a blink of an eye. We are never stable. We never have a day when we have a stable, middle ground mood. It's always up and down, intensely. Our emotions are more intense than other people's. Our reactions to things are intense and volatile. Relationships suffer because of these quickly changing, intense moods that are a result of biological and genetic reasons, and our environment. Marsha Linehan came up with a Biosocial theory for emotional dysregulation, which can be found in her DBT worksheets book as well as the training manual. Regardless, it is not biology or genetics, but also our invalidating environment, growing up and possibly now. Our anger is intense, and often our of control. We might get angry at the little things and ruminate about them for hours or days or even months. We have an easily explosive anger that can ruin relationships, friendships or ourselves. As anger was my leading cause of self harm in my life. But anger that was expressed inwardly, rather than outwardly most of the time. This is known as a Quiet Borderline. Where we internalise all of our behaviours and not outwardly express them. 

Relationships are on the black and white, all or nothing, good or bad, love and hate seesaw. They go between one side to the other. It's often called splitting. We might love you one moment, absolutely hate your guts the next. It is because of our intense emotional life, behind which lurks pain and memories from the past. But because of that past, when we were abandoned by our caregivers, we don't want people to leave us. The phrase "I hate you, don't ever leave me" very much fits most of us. Where we want for people to leave us alone, but we don;t want them to leave us at the same time. And when we feel abandonment, real or imagined, we experience intense emotions and react in ways that people might see as manipulative. Kiera Van Gelder had said in the documentary "Back From The Edge - Borderline Personality Disorder" was "Manipulation assumes that the person has the skills to think about and then execute a plan. Manipulation in that sense I don't think can be applied to people with BPD because it is all about immediate reactions and desperately trying to get something to feel secure, safe and okay again." In the same video, Marsha Linehan says "Manipulation is when you consciously try to get someone to do something for you without them knowing you actually got them to do it. These individuals (BPD sufferers) very rarely have the interpersonal skills to figure our how to get you to do things in an unobtrusive way."
I want for everyone to understand this. We are not manipulative. We might come across as that, but in reality, we are fighting desperately to feel okay. We want to feel better. And a way to do it is having the person we cling to most around us. When abandonment is perceived as real or imagined, we try to do what we can for you to not leave us. I remember when I was in church, I had two friends whom I trusted. And when I felt abandoned for a long time by one of them, I'd desperately try to be around them at all cost. I was desperate enough to send messages on Facebook constantly, to make sure they were still there. And often around those same times, I'd feel suicidal and I would express that. Not in a manipulative, but "help me, I am suffering!" way. But it could have come across as manipulative to share that just for them to stay. That was never my intention. But other sufferers go to great lengths to avoid abandonment. We are so sensitive to rejection and abandonment. For other people to leave a relationship healthily is the end of it. But for us, the suffering from the feeling of abandonment continues after a friend/relationship ends. 

I wanted to write this to help people who live with/are friends with/have a relationship/have a family member or just for people who have seen a terrible portrayal of BPD in the media. To help you to understand what it is like to live with BPD on daily basis.

And a message to those who suffer from it:
It gets better. With the right therapy, medication and support, you can make it. I am nearly eleven months into Dialectical Behaviour Therapy. Due to crises, I am gonna be in the treatment for a longer period of time. But it gets better with the skills I practice, with an amazingly supportive therapist, with a great psychiatrist and with the support of a few close friends, I am fighting through. Everyone of us struggling with BPD and/or Bipolar can make it through and live a normal life. I want to be a counselling psychologist in the future, as I want to help others power through suffering and with my understanding of emotional suffering, I can help others who feel like there's no hope for them. And there is. The truth is, there is always hope. And if we grasp the opportunities to heal with every last bit of will, strength and ability, we can make it through. And that goes for anyone suffering with any illness. I use my experiences to help others on Facebook in the support groups. And my life is enriched by helping others. So, go for it! Seek out to get better and you will! Takes time and work, but you can do it!